http://test-journals.seedmedicalpublishers.com/index.php/PMeAL/issue/feed Pratica Medica & Aspetti Legali 2019-03-26T16:44:59+00:00 Rossella Iannone r.iannone@seedmedicalpublishers.com Open Journal Systems <p>eISSN: 2283-4044</p><p><em><br /></em></p><p><em>Pratica Medica &amp; Aspetti Legali</em> è indicizzata e disponibile su:</p><ul><li><a href="http://search.crossref.org/?q=pratica+medica" target="_blank">CrossRef</a> </li><li><a href="http://scholar.google.it/scholar?hl=it&amp;q=pratica+medica+%26+aspetti+legali&amp;btnG=&amp;lr" target="_blank">Google Scholar</a></li><li><a href="https://www.openaire.eu/search/dataprovider?datasourceId=openaire____::2d6c968404a1cd0a90e36a3cf92e256e" target="_blank">OpenAIRE</a></li><li><a href="http://www.sherpa.ac.uk/romeo/search.php?issn=1973-4824" target="_blank">SHERPA/RoMEO</a></li></ul><p><em>Pratica Medica &amp; Aspetti Legali</em> è una rivista online in open access, pubblicata secondo il "continuous publication model" da <a title="SEEd" href="http://www.seedmedicalpublishers.com" target="_blank">SEEd Medical Publishers</a>.</p><p>La rivista pubblica casi commentati e lavori originali su argomenti di rischio clinico, malpractice, medicina legale e/o discipline cliniche correlate. Ampio spazio è dedicato alla <strong>casistica</strong>: i contributi sono selezionati con lo scopo di fornire un adeguato livello di informazione ai medici non specialisti di scienza medico-legale ma che hanno interesse a conoscerne i risvolti legati alla loro professione. <em>PM&amp;AL </em>pubblica inoltre articoli che descrivano i <strong>rischi di errore medico</strong> e le metodiche per la loro prevenzione, lavori sulla <strong>gestione del rischio clinico</strong> e casi che mettano in luce i possibili <strong>rischi derivanti dall’impiego di un farmaco</strong>.</p><p><em>Pratica Medica &amp; Aspetti Legali </em>fornisce accesso gratuito e immediato agli articoli in versione html, in accordo con gli standard previsti dal bando europeo H2020 e dalle linee guida per l’Open Access delle Università italiane.</p><p>La rivista non prevede costi di pubblicazione a carico degli autori e adotta un processo di referaggio con <a href="/index.php/PMeAL/about/editorialPolicies#peerReviewProcess" target="_blank">peer review</a> in doppio cieco.</p> http://test-journals.seedmedicalpublishers.com/index.php/PMeAL/article/view/1386 La mediazione trasformativa nell’era della patient revolution. Un modello per la gestione del rischio clinico e legale nelle ASL italiane 2019-03-26T16:43:01+00:00 Antonio Dodaro antonio.dodaro@hotmail.it Virginia Recchia recchia@ifc.cnr.it <p><em>[Transformative mediation in the era of the patient revolution. A model for the management of clinical and legal risk in Italian health facilities]</em></p><p>Nowadays, too many patients do not perceive that their doctors are exclusively dedicated to care them. This is probably because current health systems are too focused on physicians and diseases, rather than on patients. Such systems are also expensive, fragmented, inefficient and often cynical, generating not only the anger but also the willingness to bring legal claims from many patients. Many scholars, in fact, claim that "too much medicine" can bring more harm than good to the patients and to the health systems themselves, therefore promoting a more sober and respectful medicine. This is the vision of the "patient revolution" and the idea that inspires some other movements that aim to break the vicious circle of greed and cynicism that damages not only patients but also health professionals. Within the same vicious circle, an exponential increase in litigations takes place, as an additional negative effect of the system focused on the disease and on the doctors instead of on the patient.</p>In the present article, we assume that a greater participation of the patient in the choices concerning his/her own health is the fertile ground in which concrete solutions can be found to many problems arising from the current medicine. We therefore analyze the main advantages of active patient participation, which in turn generate a reduction in health conflicts. Based on this analysis, we propose a model in which through various approaches, tools and methods - starting from the upstream prevention of the conflicts - we can also manage them downstream, for the benefit of both patients and health professionals. Finally, we show that within this framework, transformative mediation is an essential approach for weakening many legal disputes and repairing the relational damage generated upstream, where communication has failed or is completely lacking in the clinical practice. 2018-12-21T11:03:47+00:00 Copyright (c) 2018 Gli Autori http://test-journals.seedmedicalpublishers.com/index.php/PMeAL/article/view/1349 Nel merito dei rapporti medico legali vigenti tra le assicurazioni sociali: la gestione della malattia, la surrogazione e il cumulo tra prestazioni previdenziali nella loro concreta applicazione. 2019-03-26T16:44:59+00:00 Michele Sammicheli sammicheli@alice.it Marcella Scaglione marcellascaglione@libero.it <p>The article looks at the relationships between the two main Italian Social Security Insurance Institutes: the National Institute of Social Security (INPS) and the National Institute for Insurance against Accidents at Work (INAIL).<br />The aim of the article, resulting from the daily working practices of the two Authors, is to examine the various sectors in which the two institutions are often confronted: the management of compensable illness, the subrogation, and the cases of accumulation of social security benefits provided by the two institutions for disabled persons.<br />Some practical examples are reported in order to facilitate the reader the easy understanding of the issues addressed.</p> 2018-05-28T10:35:34+00:00 Copyright (c) 2018 http://test-journals.seedmedicalpublishers.com/index.php/PMeAL/article/view/1368 Sicurezza in sala operatoria: utilizzo della tecnica FMEA/FMECA nel percorso diagnostico pre-analitico del campione biologico dalle sale operatorie ai laboratori 2019-03-26T16:44:36+00:00 Vanessa Arimatea patrizio.didenia@ior.it Patrizio Di Denia patrizio.didenia@ior.it Alessandra De Palma alessandra.depalma@aosp.bo.it Daniela Cavedagna patrizio.didenia@ior.it Concetta Brugaletta concetta.brugaletta@aosp.bo.it Elena Miani patrizio.didenia@ior.it Luca Bianciardi patrizio.didenia@ior.it <p><em>[Safety in the operating room: use of the FMEA/FMECA proactive analysis technique in the pre-analytical diagnostic pathway of the biological sample from the operating room to laboratories]</em></p><p>The inaccurate management of biological samples is one of the errors that can occur in the operating room: it can lead to a loss, incorrect labeling or storage of the sample, causing serious consequences for the patient. Proactive analysis of this high-risk process can reduce the possibility of this type of errors, improving patient safety and reliability of activities. A risk analysis technique employing proactive logic is the Failure and Effects Analysis/ Failure Mode, Effects, and Criticality Analysis (FMEA/FMECA).</p><p>This paper describes an inter-professional and inter-facility project in which the FMEA / FMECA has been applied to the biological sample path from the operating room to the destination laboratories in two healthcare facilities in Bologna: the University Hospital S. Orsola Malpighi (AOU BO) and the Rizzoli Orthopedic Institute (IRCCS IOR). The aim of the project was to improve the safety and the reliability of the routine and urgent diagnostic procedure in these healthcare facilities.</p><p>Two different working groups, belonging to the two healthcare facilities and composed of operating room doctors and nurses, have implemented the methodological steps of the FMEA/FMECA technique.</p><p>At the end of the analysis process, 16 failure mode (FM) were identified at the AOU BO and 21 at the IRCCS IOR. Each FM was assigned a risk priority index (RPI) and the main causes and improvement actions to be planned were identified.</p><p>Interventions were therefore undertaken to improve the safety and reliability of the riskiest welfare practices.</p><p>A re-evaluation of the RPIs at 6 months-1 year from the improvement interventions will be carried out.</p>The FMEA / FMECA technique gave the opportunity to the professionals involved to approach the adverse event through a new approach, which is the proactive method of risk analysis, using methods and tools for the improvement of patient safety that are independent, at least in part, from the study of the adverse event or near miss, representing an important step towards a real culture of security. 2018-07-27T10:34:20+00:00 Copyright (c) 2018 http://test-journals.seedmedicalpublishers.com/index.php/PMeAL/article/view/1377 Compiti e funzioni del medico competente e modalità di svolgimento della professione alla luce della legislazione vigente 2019-03-26T16:43:24+00:00 Alfonso Cristaudo alfonso.cristaudo@med.unipi.it Giovanni Guglielmi g.guglielmi@ao-pisa.toscana.it Fabrizio Caldi f.caldi@ao-pisa.toscana.it <p><em>[The competent physician for the assessment of risks at work: tasks, functions and conduct in the light of current legislation]</em></p><p><em><br /></em></p><p><em>Abstract non presente. Si riporta l'inizio dell'editoriale</em></p><p>Nella normativa italiana già con il Regio Decreto 530 del 1927 all’art. 6 viene introdotta la figura del medico di fabbrica, e precisato che nelle lavorazioni industriali nelle quali si adoperino o si producano sostanze tossiche o infettanti indicate in un apposito elenco i lavoratori dovranno essere visitati da un medico competente...</p> 2018-12-13T10:34:17+00:00 Copyright (c) 2018 Gli Autori http://test-journals.seedmedicalpublishers.com/index.php/PMeAL/article/view/1384 "Malasanità": breve osservazione a proposito di un singolare quesito posto ai Consulenti Tecnici d’Ufficio in un caso di accertamento tecnico preventivo ex art. 8 della cosiddetta Legge Gelli-Bianco 2019-03-26T16:43:48+00:00 Paolo Girolami paolo.girolami@unito.it <p>["Malasanità": brief observation on a singular question posed to Technical Consultants in a case of prior technical assessment pursuant to art. 8 of the so-called Legge Gelli-Bianco]</p><p><em>Abstract non presente. Si riporta l'inizio dell'editoriale</em></p><p> </p><p>Nel luglio del 2018 il Giudice di un Tribunale riceveva istanza di accertamento tecnico preventivo ex art. 8 della cosiddetta Legge Gelli Bianco (Legge n. 24/2017) [1], che, come è noto, impone, a chi voglia esercitare di fronte al Giudice «un’azione risarcitoria derivante da responsabilità sanitaria, di tentare prima un percorso negoziale al fine di verificare la possibilità di evitare il processo» [2]. </p><p>Nel caso in questione, il Giudice adíto, ai Consulenti Tecnici d’Ufficio (CTU) nominati poneva il seguente quesito: «<em>Accertare l’entità delle lesioni e postumi permanenti residuate al signor XY a seguito della</em><br /><em>mala sanità, il nesso di causa tra le lesioni lamentate e l’operato dei sanitari Usl, nonché la congruità delle spese mediche, la necessità di spese mediche future in modo da addivenire ad una composizione della lite</em>».</p> 2018-11-23T11:43:35+00:00 Copyright (c) 2018 L'Autore http://test-journals.seedmedicalpublishers.com/index.php/PMeAL/article/view/1375 Profili di responsabilità infermieristica in un caso di amputazione dell’avambraccio da errata pratica infusionale in neonato prematuro 2019-03-26T16:44:12+00:00 Luigi Pais dei Mori luigi.pais@gmail.com <p><em>[Nursing responsibility profiles in a case of forearm amputation by wrong infusion practice in a premature newborn]</em></p><p>This article refers to the case of a premature newborn twin (23 weeks of gestation + 6). Of the two brothers, only one survived, in a highly compromised state of health that led to a notable and dramatic series of clinical events: infectious complications, chronic renal failure, viscera herniation, intestinal perforation, and thrombocytopenia, treated with various infusions of platelet concentrates.</p><p>During an infusion of platelet concentrate, an extravasation occurred with important tissue infarction. The lesion created, secondary to ischemic necrosis, evolves into dry necrosis, from the hand to the whole forearm, and leads to the amputation of the right forearm, despite the various attempts, pharmacological and surgical, experienced to avoid the extrema ratio.</p><p>The purpose of this article is to analyze what happened considering scientific clinical evidence and the profile of responsibilities related to nursing practice.</p> 2018-10-31T15:33:38+00:00 Copyright (c) 2018 L'Autore